Влияние позвоночно-тазовой подвижности на технологию и исходы тотального эндопротезирования тазобедренного сустава
https://doi.org/10.52420/umj.23.5.114
EDN: WAHVXR
Аннотация
Введение. Тотальное эндопротезирование тазобедренного сустава (ТЭТБС) является одним из наиболее часто проводимых оперативных вмешательств среди пациентов с заболеваниями тазобедренного сустава. Несмотря на высокую частоту и эффективность ТЭТБС, нестабильность является основной причиной выполнения повторных оперативных вмешательств, которые оказывают значительное влияние на качество жизни пациентов.
Цель исследования. Анализ литературных данных, посвященных позвоночно-тазовым взаимодействиям, разработка рекомендаций по устранению патологий позвоночника и таза на основе проанализированных данных. В статье подробно рассматриваются классификации нарушений позвоночно-тазового взаимодействия, а также описываются методы их коррекции, которые необходимо учитывать при выполнении ТЭТБС.
Материалы и методы. Проведен поиск публикаций в электронных базах данных PubMed и eLibrary.ru по следующим поисковым терминам: «позвоночно-тазовая подвижность, тотальное эндопротезирование тазобедренного сустава, артропластика тазобедренного сустава», “vertebral-pelvic mobility, total hip replacement, hip arthroplasty”. Временной интервал поиска не ограничивался. В настоящее исследование включались статьи, опубликованные на русском и английском языках.
Результаты и обсуждение. Ориентацию тазового компонента следует планировать в соответствии с оценкой движений тазобедренного сустава, чтобы расположить тазовую часть эндопротеза в соответствии с новой безопасной зоной и комбинированным сагиттальным индексом. Однако хирург должен учитывать, что послеоперационная подвижность таза и позвоночника может отличаться от предоперационной из-за контрактуры сустава или физиологического старения позвоночника. В настоящее время еще не определено, как часто эти изменения приводят к выходу тазового компонента эндопротеза за пределы своей позиции и пространственного расположения, увеличивая риск вывиха.
Заключение. Правильное понимание взаимосвязи тазобедренного сустава и позвоночника, а также влияние их взаимодействий на позиционирование вертлужного компонента является определяющим моментом в снижении риска вывихов. «Безопасная зона» Левиннека по-прежнему может использоваться в качестве ориентира для большинства пациентов, однако пациенты с нарушениями спинально-тазовой подвижности должны быть четко идентифицированы.
Об авторе
С. Ю. Глазунов
Башкирский государственный медицинский университет
Россия
Конфликт интересов:
Россия
Станислав Юрьевич Глазунов — аспирант кафедры травматологии и ортопедии с курсом ИДПО
Уфа
Конфликт интересов:
Автор заявляет об отсутствии явных и потенциальных конфликтов интересов.
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Для цитирования:
Глазунов СЮ. Влияние позвоночно-тазовой подвижности на технологию и исходы тотального эндопротезирования тазобедренного сустава. Уральский медицинский журнал. 2024;23(5):114–124. https://doi.org/10.52420/umj.23.5.114. EDN: WAHVXR
For citation:
Glazunov SY. The Effect of Vertebral-Pelvic Mobility on the Technology and Outcomes of Total Hip Replacement. Ural Medical Journal. 2024;23(5):114–124. (In Russ.) https://doi.org/10.52420/umj.23.5.114. EDN: WAHVXR
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